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:~ one 5510-.1 OIUh'l'%ll STATES ~., ~
<br />(Jc.ubcr 1J75) ~ ~ ~. ., ~_ 1'O: i.l elVYl:U Vi~aJ
<br />Lz'';I [ah5'PGh [IT OIz 'n'Eii: 3.fQ'6'!~LSOi: c,;.1t; 1vU, ez-e0'sl~
<br />' i GUi:LAII Gig LACJU [~IAYJAULidLP1']' ~~ ~"- ~- -~_"-~ --"~~
<br />1 u 11uw r
<br />~, _ u -i
<br />I ~ ~ ~ i ~'t~-' Y-[dLi~ C6S,~ GG~~i>{~> a 4Ui3 r14J~ PtiG2F.A`u' L vu~tt~„ L ,e~
<br />~~.~, ~~ V1-GL'i /1l IVi: Ul2 i~IIWLRAL LIA 1 LRIAL ' -'" --'" "-
<br />Lxs o's~i
<br />Nance ui applieout ._--- - _-._ Gldw :;:; (include zip code) - _~~ ~.- -_ ~-.
<br />~. _.~_' C.1 iO'v' :I')dCa_ <' ' i+r'~_-' -.'I i-'ula.:,i1-i, iiJst~0rlr ~fl1.lU1"u' i.i'zl'-1
<br />i 11 J of nmterial ~ - Cswoctud quuui;i y
<br />_ _ (.' vim! ~ ~ ?COOOU ct' 2;V,
<br />~,ive Ycgal lultd dascespi!.ou _ _ _
<br />'i O:l i'JSiiIP ~ 1ua1dG1~-Sii~11Oid SU LD1V ISlOi4---~--~-- ~-~-
<br />'.!' ) 1'J It 'iv PJ ~Ci ~rri
<br />is ara to Le used iuc
<br />I Ili; x:u BY Aut:uG- iU Cut,l t~r,y 4/I'r'is the spc.:rul cundiriu,ls as cur furrtl Le1uw h ~L1:'r'1, ? l.hut Thy. (a) ^ui~rca.;
<br />to Le rcmo'ved ma cu Le used fu. the purpose uoYed aF;ov e; (U) none of Lhe wateria}s removed n;e to ue cold ur Ln, Lt,c.t;
<br />lc) rantuval vi ^mie.ials can Go~ia Duly opal receipt of an appruvad copy of this perruiT; aud, (d) Ute auihuri:;cd cn F:: c,
<br />i~ to be uutiried upuu cc~apieiun vi lemuval.
<br />1 '~a~l?'SIk'Y 'i'4mt ! am tcaeuty-cr,o yeaes of age or c1da,, a citizen of i11e United-States, atld lesidettt of ltld Su::c _t
<br />1 1~ Ut2'PHL R C;~RT`il~ Y 'Y'hat Cite aiatenleuis made Ly ri.: iu this application are true, complete, and curtact iu L',~~ bps:
<br />ut rag lalocalcd[z aud Celie't aud ara mode hr gccd faifit.
<br />Jaci:eoil ~t;e,uirc,y itv~fl `lep:_,'i=r~arc
<br />lduy'l;modi`'Jr l~)'tu ~ _.. _ !. i.U4::1, to l'+.: ,,
<br />(Dore) - ~ ~ ~~ (Sigralwo of APplicoui) ~ -~
<br />:'itle .II U.S.I. Ccciiun ZU01 ~ n '. ., ? u ~:ibra la, mxy-p..:..o~ i.uu' ~i,,;,., ..r ci dtil wlly to ;,ml,a to m~ riot~mv iutl u ~;,~u cy i.. .i...
<br />Jnime] 5:aias nay CeL ~, CiciiLi cita~ ur Guudei,c ~, sie:_mcria cr rep~e~ct,i~t-;;to °: io , p.y luaLLge c; iihi.:x iL: jm isdie ti gyn.
<br />1'~Rlvll Y. :.. ..
<br />.. ,°.PG:CIJA)_ GO{dUiY.IUPlS
<br />1'il s : r-a;r .o llz,.,by ro.,..c,1 :,, "?:,, ota1~ ~ials al 1.!.ca .;c: 4ti: ;ital. L c ~, :cY~d if ii apueul., That liz:~ p;:mi_, ..~-.
<br />r
<br />a3.:cd e,ro;i~oacly o; t{12 ie,i,1~ a co;G't~ __ .~~- s_„~d ilecain aca ^ot observod. !C shall La aubject Cu Cl:e 4u'i,:.i ,,
<br />si.ac;al cu;idiiiau>:
<br />~~eset vatiua lnacricen :nut( I:e. prai;tieed us proc~ided
<br />'Oy 4J Ll'12 SSll.1-1(h), _ ~lll~ all(1 ..,-:i~
<br />C.tluit,Iaeut, pcrsoe_l prupecty, aud iwprovements t:;a3t
<br />uu xemuved vicllin ninety (9Dj days aStec c::pir~iiuu
<br />axle (43 CFI: 3021.4(c) or 5511.3-s);
<br />-toy use of rile surface of Tho lauds involved i^ this '
<br />pc--Wait shall 6~ such au not to iui'eroca crith auy mining I
<br />cl:tii^ subject to the l.lrovisiuu3 of Sectlou d of the AcT
<br />~r ~alj' 'zs, I95s Can o.s.c. oY3);
<br />(!acne)
<br />!'I:o p2scoitica c;hnll c)caa up all tiiurl: uccu~ nt:~.i ;fm_I
<br />raniove uc diupase u all relusL lesuliiu~ Ou1~~ rlc:
<br />p~rlnii[ce's operations;
<br />"Phis paratiT 'is res ue:l under the 4ci of joIy :i±, !°, 1.'.
<br />as amended, aud 43 O.S.C. ~' aud 1'LUt.
<br />(Jinn mute of e1u(horized Uiiic%r) --~'
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